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The answer is square. Always square…well, at least when we’re talking about how to trim your toenails! Improper trimming of the nail can commonly lead to an ingrown, the proper technique for trimming will be covered in a few minutes, but for now, let’s talk ingrown toenails.

An ingrown toenail is caused by a sharp edge of the nail that digs into the surrounding skin creating pressure and pain. Improper trimming of the nail is the most common cause of an ingrown as a sharp edge or corner may remain, or too much nail has been removed allowing the nail to pinch the surrounding skin as it grows. Trauma to the nail, especially in adolescents who are actively involved in athletics, can also create an ingrown. Repetitive kicking, of a soccer ball for example, can cause the skin to pinch inwards towards the nail. Tight fitting shoes can cause the same sort of reaction, resulting in an ingrown nail. A hereditary component may exist, so if you have ingrown toenails, it is likely that your son or daughter will suffer from the same. It is not the toenail, per say, that is hereditary, but the structure of the bones within the toe that predisposes development.

The first sign of an ingrown will be pain. If the pain is ignored too long or if you attempt to relieve the pain on your own by cutting back the nail via “bathroom surgery,” infection is likely to occur. You will know infection is present when the area where the skin and nail come together begins to become red, hot, and swollen and when it begins to drain fluid. If you haven’t seen your Podiatrist, which if you’ve reached this point its likely that you haven’t, its time to give him or her a call and get an appointment as soon as possible. If you are experiencing chills, fevers, or night sweats, take yourself to the emergency room, as these are signs of systemic infection.

Treatment for an ingrown nail is very straightforward and most Podiatrists will follow a variation of the same protocol. A portion, or the entire nail needs to be removed to alleviate pressure and eliminate the source of the ingrown. Your Podiatrist will start by numbing the toe and cleaning the area around the nail to eliminate any bacteria living on the skin. Next he or she will free the underside of the nail from the toe, cut back the portion of the nail that is digging into the skin and remove it. Once it has been removed, they may or may not use a chemical called phenol to help prevent the nail from growing back. Your toe will be bandaged and you will be given instructions on how to care for the area at home. Depending on the severity of infection, you may or may not be given a prescription for antibiotics. You will need to follow-up with your Podiatrist within a week to ensure everything is improving. It is important that you do not try to remove the nail yourself, as the bone in your toe is situated directly under the bed of the nail and using unsterile techniques can lead to infection of the bone or abscess (basically a sac filled with infection).

Now, back to how to properly trim your toenails: A very common misconception the average person makes, in relation to trimming their toenails, is belief that the nails should be rounded off on the sides, keeping the edges smooth. The edges should be smooth, but rounding off the sides increases the risk of creating an ingrown toenail. As I said above, square is always better. You want to ensure that when trimming your nails, or your child’s nails, you trim straight across leaving the edges of the nail square. DO NOT try to round the edges down towards the skin and DO NOT trim the nail too low causing irritation at the end of the toe. If you’re not used to trimming your nails this way, it will take some getting used to, but I can assure you, you will thank yourself later when you’re not suffering from the discomfort associated with an ingrown toenail! The reason ingrown toenails are more predominant in those ages 8-12, is because it is around this age that children become responsible for trimming their own nails. If you, as their parent, haven’t taught them the proper technique, your Podiatrist will be seeing you soon!